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Case Report

Management of a Mycotic Aneurysm in a Patient with COVID-19: A Case Report

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Division of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
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Department of Surgery, University of Toronto, Toronto, ON M5B 1W8, Canada
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Department of Diagnostic Imaging, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
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Division of Vascular and Interventional Radiology, Health Sciences North, Northern Ontario School of Medicine, Sudbury, ON M5B 1W8, Canada
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Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
*
Author to whom correspondence should be addressed.
Academic Editor: Dainis Krieviņš
Received: 11 May 2021 / Revised: 7 June 2021 / Accepted: 11 June 2021 / Published: 14 June 2021
The aim of this paper is to share our experience in managing a patient with Klebsiella pneumoniae mycotic abdominal aortic aneurysm who was also infected with COVID-19. A 69-year-old male was transferred to our hospital for the management of an infra-renal mycotic abdominal aortic aneurysm. During his hospital course, the patient contracted severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). He was intubated due to respiratory distress. Over a short period, his mycotic aneurysm increased in size from 2.5 cm to 3.9 cm. An emergency repair of his expanding aneurysm was achieved using our previously described protocol of coating endovascular stents with rifampin. The patient was managed with a rifampin-coated endovascular stent graft without any major complications. Postoperatively, the patient did not demonstrate any neurological deficits nor any vascular compromise. He remained afebrile during his postoperative course and was extubated sometime thereafter. He was then transferred to the ward for additional monitoring prior to his discharge to a rehab hospital while being on long-term antibiotics. During his hospital stay, he was monitored with serial ultrasounds to ensure the absence of abscess formation, aortic aneurysm growth or graft endoleak. At 6 weeks after stent graft placement, he underwent a CT scan, which showed a patent stent graft, with a residual sac size of 2.5 cm without any evidence of abscess or endoleak. Over a follow-up period of 180 days, the patient remained asymptomatic while remaining on long-term antibiotics. Thus, in patients whose surgical risk is prohibitive, endovascular stent grafts can be used as a bridge to definitive surgical management. View Full-Text
Keywords: mycotic aneurysm; COVID-19; endovascular stents; rifampin; Klebsiella pneumoniae; endoleak; follow-up studies; SARS-CoV-2 mycotic aneurysm; COVID-19; endovascular stents; rifampin; Klebsiella pneumoniae; endoleak; follow-up studies; SARS-CoV-2
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MDPI and ACS Style

Syed, M.H.; Wheatcroft, M.; Marcuzzi, D.; Hennessey, H.; Qadura, M. Management of a Mycotic Aneurysm in a Patient with COVID-19: A Case Report. Medicina 2021, 57, 620. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57060620

AMA Style

Syed MH, Wheatcroft M, Marcuzzi D, Hennessey H, Qadura M. Management of a Mycotic Aneurysm in a Patient with COVID-19: A Case Report. Medicina. 2021; 57(6):620. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57060620

Chicago/Turabian Style

Syed, Muzammil H., Mark Wheatcroft, Danny Marcuzzi, Hooman Hennessey, and Mohammad Qadura. 2021. "Management of a Mycotic Aneurysm in a Patient with COVID-19: A Case Report" Medicina 57, no. 6: 620. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57060620

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